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Research ArticleResearch Briefs

External Validation of the COVID-NoLab and COVID-SimpleLab Prognostic Tools

Mark H. Ebell, Robert P. Lennon, Derjung M. Tarn, Bruce Barrett, Alex H. Krist, Huamei Dong, Xinyan Cai, Arch G. Mainous, Aleksandra E. Zgierska, Wen-Jan Tuan and Munish Goyal
The Annals of Family Medicine November 2022, 20 (6) 548-550; DOI: https://doi.org/10.1370/afm.2872
Mark H. Ebell
1Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
MD, MS
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  • For correspondence: ebell@uga.edu
Robert P. Lennon
2Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania
MD
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Derjung M. Tarn
3Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California–Los Angeles, Los Angeles, California
MD, PhD
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Bruce Barrett
4Department of Family Medicine and Community Health, University of Wisconsin, Madison, Wisconsin
MD, PhD
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Alex H. Krist
5Department of Family Medicine, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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Huamei Dong
6Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
PhD
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Xinyan Cai
1Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
MPH
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Arch G. Mainous III
7Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida
PhD
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Aleksandra E. Zgierska
8Departments of Public Health Sciences, and Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, Pennsylvania
MD, PhD
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Wen-Jan Tuan
2Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania
DHA, MS, MPH
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Munish Goyal
9Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC
MD
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    Table 1.

    COVID-NoLab and COVID-SimpleLab Risk Scores

    Risk Score and ComponentsPoints
    COVID-NoLaba
    Age group
       50-65 y3
       ≥66 y5
    Respiratory rate ≥303
    Oxygen saturation <93%2
    COVID-SimpleLabb
    C-reactive protein level >10 mg/dL5
    Respiratory rate ≥305
    Oxygen saturation <93%4
    Age group
       50-65 y6
       ≥66 y8
    Asthma4
    White blood cell count >10 × 109/mL3
    Serum creatinine level >2.0 mg/dL4
    • a Score range is 0 to 10 points. Risk groups: low (0-1 point), moderate (2-5 points), high (≥6 points).

    • b Score range is 0 to 33 points. Risk groups: low (0-7 points), moderate (8-11 points), high (≥12 points).

    • View popup
    Table 2.

    Comparison of Predicted Mortality Between Original Derivation Cohort and Quebec Validation Cohort

    Risk GroupaOriginal Derivation CohortbQuebec Validation CohortcP Valued
    Patients, %Mortality Rate, % (95% CI)SSLRPatients, %Mortality Rate, % (95% CI)SSLR
    COVID-NoLab
       Low221.3 (0.4-3.4)0.10161.1 (0.02-5.7)0.10.83
       Moderate6711.3 (9.4-13.4)0.93649.6 (6.8-13.0)0.91.36
       High1130.5 (24.4-37.0)3.202021.2 (14.2-30.0)2.00.07
    COVID-SimpleLab
       Low310.4 (0.01-2.4)0.03260.0 (0.0-2.8)0.00.46
       Moderate318.3 (5.0-12.6)0.60349.8 (5.7-15.5)0.87.59
       High3830.6 (25.3-36.4)2.204020.0 (14.6-26.4)1.80.01
    • SSLR = stratum-specific likelihood ratio.

    • ↵a See Table 1 for cutoffs for the risk groups.

    • ↵b Cohort had 1,527 patients for the COVID-NoLab risk score and 740 patients for the COVID-SimpleLab risk score.

    • ↵c Cohort had 588 patients for the COVID-NoLab risk score and 479 patients for the COVID-SimpleLab risk score.

    • ↵d From the Pearson χ2 test for the comparison of mortality rates between cohorts.

Additional Files

  • Tables
  • SUPPLEMENTAL DATA IN PDF FILE BELOW

    • Ebell_Supp.pdf
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Annals of Family Medicine: 20 (6)
Annals of Family Medicine: 20 (6)
Vol. 20, Issue 6
November/December 2022
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External Validation of the COVID-NoLab and COVID-SimpleLab Prognostic Tools
Mark H. Ebell, Robert P. Lennon, Derjung M. Tarn, Bruce Barrett, Alex H. Krist, Huamei Dong, Xinyan Cai, Arch G. Mainous, Aleksandra E. Zgierska, Wen-Jan Tuan, Munish Goyal
The Annals of Family Medicine Nov 2022, 20 (6) 548-550; DOI: 10.1370/afm.2872

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External Validation of the COVID-NoLab and COVID-SimpleLab Prognostic Tools
Mark H. Ebell, Robert P. Lennon, Derjung M. Tarn, Bruce Barrett, Alex H. Krist, Huamei Dong, Xinyan Cai, Arch G. Mainous, Aleksandra E. Zgierska, Wen-Jan Tuan, Munish Goyal
The Annals of Family Medicine Nov 2022, 20 (6) 548-550; DOI: 10.1370/afm.2872
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Subjects

  • Domains of illness & health:
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  • Methods:
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Keywords

  • COVID-19
  • SARS-CoV-2
  • risk score
  • clinical prediction rule
  • mortality
  • external validation
  • inpatients
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  • risk factors
  • clinical decision-making

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